EuroPCR 2026 – Dr Brian Bergmark (Brigham and Women's Hospital, Boston, MA, US) joins us to discuss findings from the VESALIUS-CV trial, examining the effect of evolocumab in patients who have undergone coronary stenting but have no prior myocardial infarction or stroke.

VESALIUS-CV is a double-blind, randomised, placebo-controlled, multicentre phase 3 trial enrolling 12,301 high-cardiovascular-risk adults aged 50–79 years with elevated LDL-C but no prior MI or stroke. Participants received subcutaneous evolocumab 140 mg or placebo every two weeks, with a median follow-up of approximately 4.5 years. Co-primary endpoints assessed time to CHD death, MI, or ischaemic stroke, and time to CHD death, MI, ischaemic stroke, or ischaemia-driven arterial revascularisation.

Interview Questions:

1. What is the rationale for studying PCSK9 inhibition in patients at high cardiovascular risk who have not yet experienced a myocardial infarction or stroke?
2. Can you walk us through the design of the VESALIUS-CV trial and the characteristics of the patient population enrolled?
3. What were the key findings in the subgroup of patients who had undergone coronary stenting, and how did these compare to the overall trial results?
4. What did the LDL-C reduction achieved with evolocumab translate to in terms of cardiovascular event outcomes in this population?
5. How should these findings inform lipid-lowering strategies in patients following percutaneous coronary intervention in routine clinical practice?
6. What do these data add to the evidence base for guideline-directed lipid management in patients without a prior MI or stroke?
7. What questions remain unanswered, and what are the next steps for research in this area?

Recorded onsite at EuroPCR 2026, Paris.
Editors: Jordan Rance
Videographer: Dan Brent
Support: This is an independent interview produced by Radcliffe Cardiology.